چکیده انگلیسی

This paper presents a mixed-method approach to measuring the functioning of Safe Schools/Healthy Students (SS/HS) Initiative partnerships. The SS/HS national evaluation team developed a survey to collect partners’ perceptions of functioning within SS/HS partnerships. Average partnership functioning scores were used to rank each site from lowest to highest. Sites with the most favorable perceptions of partnership functioning were defined as having average scores in the top 10% (n = 10) and sites with the least favorable perceptions of partnership functioning were defined as having average scores in the bottom 10% (n = 10). Qualitative data for these 20 sites were inductively open coded for emergent themes and analyzed for patterns using grounded theory approach. Six themes emerged that distinguished sites reporting the most favorable and least favorable perceptions of partnership functioning: partner engagement, facilitators, barriers, shared decision making, partnership structure, and sustainability. Sites reporting the most favorable perceptions of partnership functioning effectively utilized collaboration processes that facilitate coalition building, such as shared decision making, effective communication, and developing a clearly defined structure. Qualitative themes from this analysis provide evidence of validity for the partnership functioning scale used and illustrate distinguishing features between sites with the most favorable and least favorable perceptions of partnership functioning.

مقدمه انگلیسی

1.1. What is known about partnership functioning
The widespread support for the use of community collaboration models to tackle health and social problems is grounded in the understanding that those problems are inextricably linked to their social context (Stokols, 1992 and Trickett, 1984) and best addressed by ecologically valid programs (Foster-Fishman, Berkowitz, Lounsbury, Jacobsen, & Allen, 2001), which target multiple contextual levels, such as family, school, and policy settings (Bronfenbrenner, 1979 and Hawkins et al., 1992). Assumption is made that organizations in collaboration are better suited than a single organization to address complex health and social issues (Butterfoss, Goodman, & Wandersman, 1993) and effective, efficient, and sustainable outcomes are more likely when organizations collaborate (Lasker, Weiss, & Miller, 2001).
Collaboration through coalitions, however, can be challenging (e.g., Folayemi, 2001). Organizations that previously might have competed with each other for resources must develop a common vision, share funding, and integrate services. Further, organizations, such as mental health and law enforcement that use fundamentally different approaches to address social problems, must learn the policies, procedures, and language of partner organizations. Given this context, the process of building a coalition and creating synergy (i.e., creating an entity that is greater than the sum of its parts; Weiss, Anderson, & Lasker, 2002) has been identified as an outcome in and of itself (Butterfoss, Cashman, Foster-Fishman, Kegler, & Berkowitz, 2001), yet this process is also theorized as essential to accomplishing long-term outcomes (Butterfoss and Kegler, 2009 and Weiss et al., 2002).
Weiss et al. (2002) posited that coalition functioning is a factor that influences the creation of synergy. Coalition functioning describes the degree to which coalition-building processes have been well implemented (Zakocs & Edwards, 2006). Examples of the internal processes included in measuring coalition functioning are: communication (Kegler et al., 2005), leadership (Allen, 2005), governance (Weiss et al., 2002), member involvement (Feinberg, Greenberg, & Osgood, 2004), and influence in decision making (Kegler, Steckler, McLeroy, & Malek, 1998). Coalitions with higher internal functioning could be more likely to achieve desired community-level outcomes (Zakocs & Edwards, 2006). High internal coalition functioning is positively associated with perceived coalition effectiveness (Feinberg et al., 2004), perceived accomplishments (Kegler et al., 2005), perceived impact of the coalition on the prevention system (Hays, Hays, DeVille, & Mulhall, 2000), number of prevention activities implemented (Kegler, Steckler, Malek, & McLeroy, 1998), and adoption of evidence-based practices (Jasuja, Chou, Bernstein, Wang, McClure, & Pentz, 2005). These results are evidence for the importance of examining partnership functioning when evaluating community coalitions and their outcomes.
To date, studies of coalition functioning have primarily used quantitative methods—surveys in which coalition leaders and members rate their agreement with statements about coalition characteristics such as communication, leadership, and member involvement. Butterfoss et al. (2001) argued that qualitative methods are necessary to further examine coalition functioning because qualitative data often better represent the community's experience and avoid reducing complex phenomena to simple constructs. For example, qualitative methods would provide a deeper understanding of the effects of barriers, such as turnover in leadership and key staff, on coalition functioning (Butterfoss et al., 2001).
1.2. Safe Schools/Healthy Students Initiative
The Safe Schools/Healthy Students (SS/HS) Initiative requires a partnership between the school district(s), mental health, law enforcement, and juvenile justice agencies in grant recipient communities. Frequently, the partnership includes representatives of other community organizations (e.g., early childhood and youth development, faith-based, government, health care, behavioral health treatment services) as dictated by local needs. The national evaluation team's program theory model conceptualized SS/HS partnership functioning as contributing to short- and long-term outcomes (author et al., this issue). The national evaluation team used a mixed-method approach to illustrate the internal processes associated with the lowest and highest ends of the distribution of partnership functioning scores. Quantitative data represent partners’ perceptions of their partnership's internal functioning; qualitative data capture partners’ experiences in collaboration and grant implementation. This paper presents results of analyses using both datasets to examine whether SS/HS partnerships with low or high scores on a partnership functioning measure demonstrated characteristics qualitatively similar to other partnerships in the same low or high score category.

نتیجه گیری انگلیسی

The national evaluation of the SS/HS Initiative used a mixed-method approach to obtain deeper insight into the functioning of SS/HS partnerships. Results of the thematic analysis revealed that sites with the most favorable perceptions of partnership functioning shared qualitatively similar characteristics, as did sites with the least favorable perceptions of partnership functioning. Further, these characteristics effectively differentiated sites with the most and least favorable perceptions. Partnership operational processes (engaging partner members, shared decision making, and the ability to jointly problem solve and compromise) and partnership structural clarity, as highlighted in these qualitative data, mirror processes and structural characteristics associated with better coalition functioning (Emshoff et al., 2007 and Kegler et al., 1998a).
The current thematic results differentiating sites with the most and least favorable perceptions of functioning also provide evidence of validity for the national evaluation team's use of its partnership functioning scale. Qualitative data are often used to triangulate the findings from quantitative measures (Marshall and Rossman, 1995, Miles and Huberman, 1994 and Patton, 2002). The thematic analysis corroborated the scale's differentiation of sites based on key characteristics of partnership functioning. The scale's strong psychometric properties point to its utility for multivariate analyses relating partnership characteristics to long-term grant outcomes.
The emergence of sustainability planning as a theme differentiating sites with the most and least favorable perceptions of functioning is noteworthy as sustainability has been identified as a coalition outcome resulting from a variety of high internal functioning and implementation characteristics (Butterfoss & Kegler, 2009). Extant literature suggests that clear coalition structure, community buy-in, and sustainability planning—themes that emerged from this analysis—contribute to the sustainability of coalitions over time (National Opinion Research Center, 2010). Further, findings from one of the few empirical studies of coalition sustainability showed that sustainability planning and internal functioning were associated with short-term coalition sustainability (Feinberg, Bontempo, & Greenberg, 2008). Future empirical study of the relationship between coalition processes and sustainability would benefit the community coalition knowledge base.
The mixed-method approach used for this analysis demonstrated the utility of incorporating qualitative data into the study of community coalitions. For example, the qualitative data provided an opportunity to learn about the types of challenges partnerships experienced in addition to how partnerships negotiated these challenges. This knowledge might serve as one source to inform technical assistance provided to grantees and lends support to the assertion that qualitative data are able to more fully represent a coalition's experience than quantitative data (Butterfoss et al., 2001).
Similar to most research on community coalitions, this study has several limitations. First, the analysis sought to comprehensively examine sites at the highest and lowest ends of the partnership functioning score distribution in Year 2 of the grant cycle. The characteristics of partnerships at either end of the partnership functioning score distribution might not generalize to partnerships that (a) have more moderate levels of perceived partnership functioning, (b) are at different points in their grant cycle, or (c) were formed for purposes other than that of SS/HS partnerships. Second, partnership functioning data represent the time period of data collection and do not describe functioning for the entire grant year. Third, although extant literature has identified leadership as an important coalition functioning attribute (e.g., Zakocs & Edwards, 2006), it did not emerge as a theme in this analysis, perhaps because the interview protocols lacked explicit questions about leadership. The national evaluation team plans to include questions about SS/HS leadership in future qualitative data collections.
Despite these limitations, this investigation of the functioning of SS/HS partnerships, a distinctive collaboration among four required community partners (juvenile justice, law enforcement, mental health agencies, and the school district) administered jointly by the Departments of Education and Health and Human Services, has contributed to the empirical literature of community coalitions in multiple ways. Findings reiterated coalition processes important to coalition functioning and identified potential overlap in characteristics important to both functioning and sustainability. Results also validated the content of the partnership functioning scale used by the national evaluation team. Future studies of coalition functioning that use a mixed-method approach would further contribute to extant literature by advancing understanding of coalition development and may help to elucidate factors that underlie the sustainability of coalitions.